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13 Cards in this Set
- Front
- Back
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What makes a drug a vesicant agent?
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-when they have potential to cause significant tissue injury, including necrosis, if they leak out of vascular space
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What is the difference between an irritant agent and a vescicant agent?
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an irritant can cause inflammation (aching, burning, tightness, pain & phlebitis) but does NOT have potential to cause tissue destruction
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What is the inadvertent administration of fluid into the tissue surrounding the vascular space?
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extravasation - degree of damage depends on type, dilution, & amount of agent extravsated
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What 2 categories are vescicants placed in?
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1. DNA-binding
2. Non-DNA binding |
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How do DNA-binding agents cause ongoing damage?
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produce free radicals that bind to cellular DNA, causing drug to be taken up by healthy cells
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What intervention can help contain the damage if extravasation occurs w/ DNA-binding agent?
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minimizing dilution
applying cold compress to site *damage may not be known for days to weeks |
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What DNA-binding agents are the most potent vesicants?
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Anthracyclines
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Why do the non-DNA-binding agents cause less damage?
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injury is confined to tissues directly affected at the time of extravasation
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What is the best course of action should a non-DNA binding agent extravasate?
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Diluting & diffusing by administering heat & appropriate antidote
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What is the best way to avoid extravasation?
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Prevention
- chemo-trained RNs must administer - CVL preferred - PIV, site selection & monitoring (avoid vessels over joints) - transparent dressings |
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What are the 2 techniques described to deliver chemo via PIV?
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Two-syringe technique (push-pull to check for blood flow)
Side-arm technique (inject in side-port on IV tubing) |
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What one should do if extravasation is suspected or occurs?
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- stop infusion immediately (do not remove needle & do not flush line)
- assess patient for pain, burning & infiltration close to site - notify provider - attempt to withdraw 3-5ml of fluid from site - apply heat or cold compress& identify antidote and administer as directed - if anthracycline (evaluate for next few days w/Wood's lamp) |
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Table 4-6 (page 91)
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Vesicant & Irritant Agents & Interventions for Extravasation
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